Last updated on: 7/23/2018 | Author: ProCon.org

Is a Physician ever Obligated to Help a Patient Die?

General Reference (not clearly pro or con)

Margaret Battin, MD, Distinguished Professor of Philosophy and Adjunct Professor of Internal Medicine, and Timothy Quill, MD, Professor of Medicine, Psychiatry, and Medical Humanities at the University of Rochester, wrote in the introduction to their 2004 book Physician-Assisted Dying: The Case for Palliative Care & Patient Choice:

“Every study of physician practice in the United States… shows a measurable, fairly consistent incidence of physician-assisted suicide whether legal or not.”

2004 - Timothy E. Quill, MD Margaret P. Battin, PhD

Sissela Bok, PhD, Fellow at the Harvard Center for Population and Development Studies, wrote in the 1998 book Euthanasia and Physician-Assisted Suicide: For and Against, that:

“Both sides can point, furthermore, to much recent survey evidence, to the effect that physicians, nurses, and other health professionals are already putting patients to death. Some do so surreptitiously; others do so in secret, only to acknowledge having done so once the acts are completed.”

1998 - Sissela Bok, PhD

Charles H. Baron, PhD, Professor of Law at Boston College Law School wrote in the 2004 book Physician-Assisted Dying: The Case for Palliative Care and Patient Choice that:

“Despite the illegality of physician-assisted suicide and euthanasia, many health care professionals admit to engaging in one or the other practice when they feel circumstances require it… Although the American Medical Association takes a public stand against physician-assisted suicide, it seems opposed only to its legalization, not to its practice. Despite a number of articles reporting fairly widespread practice of physician-assisted suicide–some of them published in the pages of its own journal–the association has not taken steps to find out who these physicians are in order to have them disciplined.”

2004 - Charles H. Baron, PhD

Diane Meier, MD, Director of the Center to Advance Palliative Care, et al. wrote in their 2003 article, “Characteristics of Patients Requesting and Receiving Physician-Assisted Death,” that appeared in the Archives of Internal Medicine:

“Of 1902 respondents [physicians involved in care of the seriously ill]…respondents reported 415 requests for aid in dying… Respondents reported honoring 32 requests for prescriptions (40% of 80 requests honored), 43 requests for injections (54%), and 5 nonspecific requests for either type of assistance (6%)…

The majority of acts of physician-assisted death in this study were defined by the survey’s physician respondents as lethal injections (54% of 80 honored requests) as opposed to lethal prescription (40% of honored requests)…both acts were illegal at the time of this survey.”

2003 - Diane Meier, MD

Diane Meier, MD, Director of the Center to Advance Palliative Care, et al., wrote in a 2003 article, “A National Survey of Physician-Assisted Suicide and Euthanasia in the United States,” that appeared in The New England Journal of Medicine:

“Eleven percent of the physicians [1,902 total] said that under current legal constraints, there were circumstances in which they would be willing to hasten a patient’s death by prescribing medication, and 7 percent said that they would provide a lethal injection… Since entering practice, 18.3 percent of the physicians…reported having received a request from a patient for assistance with suicide and 11.1 percent…had received a request for a lethal injection. Sixteen percent of the physicians receiving such requests…or 3.3 percent of the entire sample, reported that they had written at least one prescription to be used to hasten death, and 4.7 percent…said that they had administered at least one lethal injection.”

2003 - Diane Meier, MD

Ezekiel Emanuel, MD/PhD, Chair of the Department of Clinical Bioethics at the Warren G. Magnuson Clinical Center, National Institutes of Health, et al. wrote in their 1998 article, “The Practice of Euthanasia and Physician-Assisted Suicide in the United States: Adherence to Proposed Safeguards and Effects on Physicians,” that appeared in the Journal of the American Medical Association:

“A total of 355 oncologists…were interviewed on euthanasia and PAS [physician-assisted suicide]. On 2 screening questions, 56 oncologists (15.8%) reported participating in euthanasia or PAS.”

1998 - Ezekiel Emanuel, MD, PhD

PRO (yes)

Pro

Timothy E. Quill, MD, Professor of Palliative Care, Medicine and Psychiatry at the University of Rochester, in an Aug. 25, 2016 article, “Should Physicians Help Terminal Patients Die?,” available at medscape.com, stated:

“It would be hard for me to construct addressing the suffering of a terminally ill patient as a harm. It is an obligation. The question is, how we can respond to those kinds of sufferings? Part of our job, in my opinion, is to help people die better. I say that in a direct way because it irks me when we say that doctors should not help people die. We need people who are committed to caring for people all the way through to their death as if they were family members, committed to relieving their suffering. Sometimes that requires helping people to die. It is not a happy day when we are taking people off life support. We do not like to do it. Sometimes we dream about it afterward. But we do it because we have to do it, because the patient is saying that they do not want it anymore. They have had it. We understand. We all talk about it. We make sense of it. We support each other.”

Aug. 25, 2016 - Timothy E. Quill, MD

Pro

Amir Attaran, LLB, DPhil, MS, Professor of Law and Medicine at the University of Ottawa, in a Nov. 13, 2015 article, “Doctors Can’t Refuse to Help a Patient Die–No Matter What They Say,” available at ipolitics.ca, stated

“I think the CMA’s [Canadian Medical Association] position is cowardly and stupid. If physicians are not duty-bound to assist patients with what the [Canadian] Court pointedly labeled “physician-assisted dying“, then who does the CMA think should be obliged to help — elves, maybe? And while it is great for doctors to provide information and options, that is but a small part of what society trains and licenses them to do.
Granted, some doctors conscientiously object to assisted dying — but if the situation arises, they cannot refuse to help their patients access what is now part of the legal standard of care.”

Nov. 13, 2015 - Amir Attaran, LLB, DPhil, MS

Pro

Rosamond Rhodes, PhD, Director of Bioethics Education at Mount Sinai School of Medicine, wrote in her chapter, “Physicians, Assisted Suicide, and the Right to Live or Die,” that appeared in the 1998 book Physician Assisted Suicide: Expanding the Debate:

“A doctor’s commitment to acting for patients’ good creates a clear obligation to help a patient avoid an agonizing, protracted death. Allowing a patient to suffer when the suffering could be ended is an obvious violation of the duty of beneficence…

Sometimes, because of special features of the need, or because of the special relationship, or because of the uniqueness of the knowledge involved, a physician may have a professional obligation to assist in a suicide or perform euthanasia.”

1998 - Rosamond Rhodes, PhD

Pro

Margaret Battin, PhD, Distinguished Professor of Philosophy at the University of Utah, wrote in her chapter, “Is a Physician Ever Obligated to Help a Patient Die?” that appeared in the 1998 book Regulating How We Die: The Ethical, Medical, and Legal Issues Surrounding Physician-Assisted Suicide:

“It is my view that even the physician with the most profound moral scruples against physician-assisted suicide can, in certain circumstances, incur an obligation to provide this assistance… I hasten to add that I support the legal recognition of opt-out provisions… But that does not mean that a physician has no moral obligation to help, even if there is no legal one… Where the patient’s request really does originate in autonomy and in the claim to mercy, it does mean that the physician is obligated not to entrap the patient into compliance with the physician’s values rather than the patient’s own values.”

1998 - Margaret P. Battin, PhD

CON (no)

Con

Death with Dignity, in an article, “How Death with Dignity Laws Work,: accessed on July 12, 2018, available at deathwithdignity.org, stated:

“It is important to discuss your end-of-life wishes with your physician as early as possible. The benefit of doing this even if you are healthy is that if your physician does not share your values on this subject, you will have the chance to look for a willing physician while you still have the energy and time to do so… It is important to have this discussion [about physician-assisted suicide] with your physician in person. Do not ask their office staff, nurse, or assistant or leave a request on their voice mail. Above all, avoid demanding your physician’s assistance. Under death with dignity laws your physician is not required to participate and may have valid reasons for declining.”

July 12, 2018 - Death with Dignity National Center (DDNC)

Con

The Canadian Medical Association, in an Oct. 2015 article, “Principles-Based Recommendations for a Canadian Approach to Assisted Dying,” available cspcp.ca, stated:

“Physicians are not obligated to fulfill requests for assisted dying. There should be no discrimination against a physician who chooses not to participate in assisted dying. In order to reconcile physicians’ conscientious objection with a patient’s request for access to assisted dying, physicians are expected to provide the patient with complete information on all options available to them, including assisted dying, and advise the patient on how they can access any separate central information, counseling, and referral service.”

Oct. 2015 - Canadian Medical Association

Con

Edmund Pellegrino, MD, Director of the Center for Clinical Bioethics at Georgetown University, wrote in his chapter, “The False Promise of Beneficent Killing,” that appeared in the 1998 book Regulating How We Die: The Ethical, Medical, and Legal Issues Surrounding Physician-Assisted Suicide:

“Euthanasia and assisted suicide are not ethical obligations of physicians… The prohibition against physician participation in euthanasia and assisted suicide has been elemental in the traditional ethics of medicine for a long time… These acts [euthanasia and assisted suicide] are far from being established morally or accepted professionally.”

1998 - Edmund Pellegrino, MD

Con

Stefan Bernard Baumrin, MD, JD, Professor of Philosophy at the City University of New York, wrote in his chapter, “Physician, Stay Thy Hand!” that appeared in the 1998 book Physician Assisted Suicide: Expanding the Debate:

“Nothing, absolutely nothing, requires that physicians be the instruments of suicide aid… The physician’s task is to tell the patient…what’s wrong, and to the best of the doctor’s ability, what is going to happen. The physician’s job is to heal the sick, to stave off death, and to say as best as he or she can what the future will be like for each particular patient. The physician gets to be the helpless person’s medical guide because he or she is trusted to hold the patient’s good uppermost, and the patient’s good does not include death.”

1998 - Stefan Bernard Baumrin, PhD, JD